Efficacy and Safety of Breviscapine Injection combined with Conventional therapy for Unstable Angina Pectoris: A Meta-Analysis of randomized control trials

To systematically evaluate the efficacy and safety of Breviscapine injection as an adjunct to conventional Western medicine therapy for treating unstable angina pectoris (UAP). Randomized controlled trials (RCTs) comparing Breviscapine combined with conventional therapy to conventional therapy alone in patients with UAP were searched and retrieved from Chinese and English databases up to June 2025. Cochrane tool was used to assess the risk of bias. Meta-analyses were performed using RevMan 5.3 and STATA 18 software, and the quality of evidence was rated using the GRADE system. A total of 46 RCTs were included. Compared with conventional therapy alone, the combined therapy significantly increased the clinical effective rate (RR = 1.24, 95% CI 1.20, 1.28, p < 0.00001) but lowered frequency of angina attacks (MD = -1.90, 95% CI -2.97, -0.84, p = 0.0005). There were superior improvements in hemorheological parameters, including plasma viscosity (MD = -0.27, 95% CI -0.44, -0.10, p = 0.002), with a favorable safety profile. As an adjunct to conventional therapy, Breviscapine injection demonstrates certain clinical benefits in patients with UAP, including relief of anginal symptoms and improvement in electrocardiographic outcomes, with an acceptable safety profile. Breviscapine injection hold potential in the clinical management of unstable angina. Therefore, rigorous, high-quality randomized controlled trials should be conducted before wide adoption.